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General NPI Number Information
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NPI Number | 1982182721
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Entity Type | Organization
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Legal Business Name | CAPITAL FACIAL PLASTIC SURGERY LLC
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 2 WISCONSIN CIR STE 820
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City | CHEVY CHASE
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State | MD
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Zip | 20815-7033
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Country | US
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Telephone | 240-630-8449
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Fax | 240-235-2255
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Provider Business Mailing Address
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Address Line | 7109 44TH ST
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6038
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Country | US
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Telephone | 240-630-8449
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | ADAM E SINGLETON
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Credential | MD
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Telephone | 240-630-8449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | D84808
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License Number State | MD
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